Implementation science is a new field that aims to scale up and sustain the application of evidence-based practice. It primarily studies the dissemination, adoption, evaluation, and improvement, etc. of the implementation process of evidence-based practice. In recent years, tens of implementation theories, frameworks and models have been developed. We systematically collected 41 of them and classified them into several categories. The first is the classical theories which are extended from the traditional social science and used as the predecessors of the implementation science. The second category is the implementation science frameworks/models that are derived from the first category, and can be divided into four groups: 1) the implementation models that explain the law of a certain aspect in the implementation; 2) the implementation determinants frameworks that summarize and classify the implementation determinants; 3) the process models that discuss how research translates into practice; 4) the evaluation models that evaluate the implementation and outcome. The implementation science theories can provide implementation researchers with valuable guidance for development of implementation strategies and evaluation of implementation outcomes.
N-of-1 trial design offers a methodologically sound approach to determining optimum treatment for an individual patient and solves some limitations of randomized controlled trials. This design could offer an efficient method of reaching a personal treatment regime tailored to suit individual needs and preferences. The paper introduces practical application, objects and the implementation process of N-of-1 trial, to explore its design points and implementation.
ObjectiveTo analyze the problems in the construction of internal control in colleges and universities, and to explore the implementation path suitable for colleges and universities. MethodsThe relevant documents on the internal control construction of universities at home and abroad were retrieved, and the case study of the implementation path of the internal control system construction of C university was analyzed by using the methods of expert interviews, flow charts and walk-through tests. ResultsThe internal control system of colleges and universities takes digital intelligence as the technical support to explore the implementation path of "external standard rule riveting point, internal standard post entry process; data standardization, process progress visualization; speed of operation tracking, data backtracking to find deviation; business data is all smooth, performance evaluation to promote management", optimize the process and improve the system, real-time extraction of operation data for key projects to track, and shorten the business operation time by more than half. ConclusionThe case university carries out empirical research on the internal control system, based on the principle of effective implementation, makes full use of the digital intelligence technology to extract the whole process data of the business system across the system, and realizes the efficient collaboration, early warning and evaluation, and scientific decision-making of the "digital intelligence" platform.
Effectiveness-implementation hybrid designs can test the effectiveness of interventions and the outcomes of implementation strategies concurrently and accelerate the transformation of research results into routine practice. This paper introduced three types of effectiveness-implementation hybrid designs and corresponding reporting guidelines, including standards for reporting implementation studies, cluster randomized design and CONSORT 2010, stepped-wedge cluster randomized design and extended version CONSORT 2018, qualitative research and COREQ reporting guideline, and provide references for domestic researchers to produce research reports on effectiveness-implementation hybrid design.
ObjectiveTo analyse the quality of implementation in clinical application guidelines of the Chinese patent medicines for the treatment of common diseases. MethodsWe retrieved clinical application guidelines of the Chinese patent medicines for the treatment of common diseases published from February, 2019 to August, 2022 in databases. The clinical practice guideline (CPG) implementation evaluation tool was used to evaluate the implementation of the included guidelines. ResultsA total of 29 guidelines were included. The implementation quality of included guidelines was moderate. Thirteen (44.8%) were high quality and 16 (55.2%) were moderate quality. ConclusionThe quality of implementation of clinical application guidelines of the Chinese patent medicines for the treatment of common diseases is higher than that of other traditional Chinese medicine CPG. The CPG implementation evaluation tool can be used in traditional Chinese medicine CPGs and particularity of TCM should also be considered.
The consolidated framework for implementation research (CFIR) is one of the most commonly used theoretical frameworks for implementation science. The updated CFIR was optimized based on the original version. The background, process and contents of the updated CFIR were introduced, and the domains and constructs of the updated CFIR were interpreted in this article. We analyzed the similarities and differences of the updated CFIR compared with the original CFIR, in order to provide methodological references for Chinese researchers to explore the determinants of implementation.
ObjectiveTo evaluate the reliability and validity of Guideline Implementation Success Assessment Tool (A-GIST). MethodsWith the guideline for the prevention and treatment of type 2 diabetes mellitus in China (2020 edition) as the target guideline, health care providers and patients from different hospitals across the country were investigated by questionnaire using A-GIST. Spearman-Brown coefficient and Cronbach's α coefficient were used to evaluate the split-half reliability and internal consistency reliability, while the structural validity, convergent validity and discriminant validity were investigated by confirmatory factor analysis based on structural equation. ResultsThe internal consistency reliability and split half reliability coefficients of the whole tool and each dimension ranged from 0.650 to 0.986. The scale-level content validity index (S-CVI/Ave) of content validity was 0.846. Confirmatory factor analysis showed that, the χ2/df of two sections of the tool were 8.695 and 6.123, respectively. The root mean square residual (RMR), the standard root mean square residual (SRMR) and the root mean square error of approximation (RMSEA) were under or almost under the threshold. Besides, the goodness-of-fit index (GFI) of them were 0.901 and 0.822, the adjusted goodness-of-fit index (AGFI) were 0.836 and 0.787, and the parsimonious normed fit index (PNFI) were 0.545 and 0.788, respectively. ConclusionGuideline Implementation Success Assessment Tool (A-GIST) was proved to be valid and reliable, and it shows that it is necessary to optimize the items under the dimensions of maintenance and evaluation of diagnosis and treatment effect in the future.
Evidence-based evidence translated into health care services requires three conversion processes, preclinical research-clinical research-implementation research, which might take a very long time. In order to speed up the process of research results translated into daily medical practice and health policy, an effectiveness-implementation hybrid design combining the effectiveness research of clinical and implementation research was emerging. This paper introduced the concept, classification and application of effectiveness-implementation hybrid design, to provide references for researchers in this area.
The consolidated framework for implementation research (CFIR) extracted, analyzed and integrated many published theories, frameworks and models of implementation research, and provided a comprehensive and practical theoretical framework for researchers to explore the influencing factors in the implementation of evidence. This paper introduces the origin, core content and application examples of CFIR in evidence-based nursing practice, in order to provide reference for researchers to use CFIR to carry out implementation research.
Objective To evaluate the implementation effects and problems about quota payment of specific diseases for hyperplasia prostate and ureteral calculi in Chengdu. Methods Payments, man-time of operation, and the lengths of hospitalization of hyperplasia prostate and ureteral calculi as quota payment of specific diseases in Chengdu from 2013 to 2015 were analyzed by using SPSS 16.0 software. Results Based on the standards of medical expense limitation in Chengdu unchanged, tertiary and secondary hospitals remained surplus with quota standards of single diseases unchanged. The average lengths of hospitalization of hyperplasia prostate and ureteral calculi in tertiary and secondary hospitals were significantly decreased (P<0.05). Conclusion The application of quota payment policy for single disease in Chengdu city of Sichuan province has been proved to work on controlling the medical expense of treating hyperplasia prostate and ureteral calculi. Our results indicate the continuous implementation of quota payment policy. However, the exploration of proper payment standardization, enhance of hospital supervision and establishment of efficient system are still needed to define.